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NPI Code Detail

MEDICARE: ADRIENNE NICOLE POLITE D.O.

MEDICARE:   ADRIENNE NICOLE POLITE  D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician72417GA

General Provider Information

NPI Number : 1740454875
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADRIENNE NICOLE POLITE D.O.
Provider Business Mailing Address
First Line : 1605 ROBERTA DR SW
Second Line :
City : MARIETTA
State : GA
Zip : 30008-3855
Country : US
Telephone Number : 770-419-3120
Fax Number :
Provider Business Practice Location Address
First Line : 1605 ROBERTA DR SW
Second Line :
City : MARIETTA
State : GA
Zip : 30008-3855
Country : US
Telephone Number : 770-419-3120
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2008
Last Update Date : 09/12/2014

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Directions to “ ADRIENNE NICOLE POLITE D.O.” Practice Location

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